General Neurocognitive Functioning Research Articles

Spontaneous perspective-taking and its relation to schizotypy

ABSTRACT Introduction Patients with schizophrenia differ from healthy controls in the extent that they spontaneously take another’s perspective. For such effects, it is difficult to separate the influence of schizophrenia from multiple potential confounders. Here, for the first time, associations between spontaneous perspective-taking and schizotypy were investigated in a nonclinical population. Methods Adult participants completed both a Schizotypal Personality Questionnaire (SPQ-BRU) and a novel online adaptation of a visual perspective-taking task that required participants to make judgements both from their own perspective and that of a human avatar. Results Response times were elevated when the avatar’s perspective was inconsistent with that of the participant, providing evidence of spontaneous perspective-taking. This demonstrates that the visual perspective-taking task can be successfully implemented in an online format. However, schizotypy did not predict these spontaneous perspective-taking effects. Conclusions Unlike explicit mentalising, this form of implicit mentalising is not affected by nonclinical manifestations of schizotypy traits. This implies that impairment of general neurocognitive function contributes to altered spontaneous perspective-taking in schizophrenia. A novel account based on the cognitive control processes involved in perspective selection and the role of attention in perspective calculation reconciles apparently contradictory findings of earlier studies comparing patients with schizophrenia and healthy controls.

Conduct disorder symptomatology is associated with an altered functional connectome in a large national youth sample.

Conduct disorder (CD), characterized by youth antisocial behavior, is associated with a variety of neurocognitive impairments. However, questions remain regarding the neural underpinnings of these impairments. To investigate novel neural mechanisms that may support these neurocognitive abnormalities, the present study applied a graph analysis to resting-state functional magnetic resonance imaging (fMRI) data collected from a national sample of 4,781 youth, ages 9-10, who participated in the baseline session of the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®). Analyses were then conducted to examine the relationships among levels of CD symptomatology, metrics of global topology, node-level metrics for subcortical structures, and performance on neurocognitive assessments. Youth higher on CD displayed higher global clustering (β = .039, 95% CIcorrected [.0027 .0771]), but lower Degreesubcortical (β = -.052, 95% CIcorrected [-.0916 -.0152]). Youth higher on CD had worse performance on a general neurocognitive assessment (β = -.104, 95% CI [-.1328 -.0763]) and an emotion recognition memory assessment (β = -.061, 95% CI [-.0919 -.0290]). Finally, global clustering mediated the relationship between CD and general neurocognitive functioning (indirect β = -.002, 95% CI [-.0044 -.0002]), and Degreesubcortical mediated the relationship between CD and emotion recognition memory performance (indirect β = -.002, 95% CI [-.0046 -.0005]). CD appears associated with neuro-topological abnormalities and these abnormalities may represent neural mechanisms supporting CD-related neurocognitive disruptions.

Neurocognitive functioning predicts suicidal behaviour in young people with affective disorders

BackgroundNeurocognitive impairment is recognised as a risk factor for suicidal behaviour in adults. The current study aims to determine whether neurocognitive deficits also predict ongoing or emergent suicidal behaviour in young people with affective disorders. MethodsParticipants were aged 12-30 years and presented to early intervention youth mental health clinics between 2008 and 2018. In addition to clinical assessment a standardised neurocognitive assessment was conducted at baseline. Clinical data was extracted from subsequent visits using a standardised proforma. ResultsOf the 635 participants who met inclusion criteria (mean age 19.6 years, 59% female, average follow up 476 days) 104 (16%) reported suicidal behaviour during care. In 5 of the 10 neurocognitive domains tested (cognitive flexibility, processing speed, working memory, verbal memory and visuospatial memory) those with suicidal behaviour during care were superior to clinical controls. Better general neurocognitive function remained a significant predictor (OR=1.94, 95% CI 1.29- 2.94) of suicidal behaviour in care after controlling for other risk factors. LimitationsThe neurocognitive battery used was designed for use with affective and psychotic disorders and may not have detected some deficits more specific to suicidal behaviour. ConclusionContrary to expectations, better neurocognitive functioning predicts suicidal behaviour during care in young people with affective disorders. While other populations with suicidal behaviour, such as adults with affective disorders or young people with psychotic disorders, tend to experience neurocognitive deficits which may limit their capacity to engage in some interventions, this does not appear to be the case for young people with affective disorders.

Pediatric traumatic brain injury affects multisensory integration.

To investigate the impact of pediatric traumatic brain injury (TBI) on multisensory integration in relation to general neurocognitive functioning. Children with a hospital admission for TBI aged between 6 and 13 years (n = 94) were compared with children with trauma control (TC) injuries (n = 39), while differentiating between mild TBI without risk factors for complicated TBI (mildRF-; n = 19), mild TBI with ≥1 risk factor (mildRF+; n = 45), and moderate/severe TBI (n = 30). We measured set-shifting performance based on visual information (visual shift condition) and set-shifting performance based on audiovisual information, requiring multisensory integration (audiovisual shift condition). Effects of TBI on set-shifting performance were traced back to task strategy (i.e., boundary separation), processing efficiency (i.e., drift rate), or extradecisional processes (i.e., nondecision time) using diffusion model analysis. General neurocognitive functioning was measured using estimated full-scale IQ (FSIQ). The TBI group showed selectively reduced performance in the audiovisual shift condition (p = .009, Cohen's d = -0.51). Follow-up analyses in the audiovisual shift condition revealed reduced performance in the mildRF+ TBI group and moderate/severe TBI group (ps ≤ .025, ds ≤ -0.61). These effects were traced back to lower drift rate (ps ≤ .048, ds ≤ -0.44), reflecting reduced multisensory integration efficiency. Notably, accuracy and drift rate in the audiovisual shift condition partially mediated the relation between TBI and FSIQ. Children with mildRF+ or moderate/severe TBI are at risk for reduced multisensory integration efficiency, possibly contributing to decreased general neurocognitive functioning. (PsycINFO Database Record

Neurocognition and psychosocial functioning in adolescents with bipolar disorder

BackgroundAdults with bipolar disorder demonstrate significantly poorer psychosocial functioning and neurocognition compared to controls. In adult bipolar disorder neurocognition predicts a substantial portion of variance in functioning. Adolescents with bipolar disorder have reducedpsychosocial functioning, but less is known about neurocognitive impairments, and no studies have examined the relationship between neurocognition and functioning in an adolescent sample. Methods38 adolescents with bipolar disorder and 49 healthy controls under 20 years of age completed assessments of psychosocial functioning, neurocognitive ability, and psychiatric symptoms. ResultsAdolescents with bipolar disorder had significantly poorer psychosocial functioning in domains of daily activities, social functioning, and satisfaction with functioning, ps<.006, compared to healthy controls. They also had poorer general neurocognitive functioning than controls, p=.004, with the greatest impairment on a test of sustained attention. Neurocognition was not a significant predictor of psychosocial functioning in this sample, but depressive symptoms significantly predicted functioning in all domains, p<.033. LimitationsLimited sample size did not allow for complex statistical analyses. Differences in demographic characteristics of the clinical and control groups may limit generalization of these results. ConclusionsThis adolescent sample with bipolar disorder experiences significantly poorer neurocognitive and psychosocial functioning compared to controls; however, psychosocial functioning appears to be more strongly related to mood symptoms than to neurocognition. Future work is needed to delineate the time course of neurocognitive functioning and its relation to psychosocial functioning across the course of illness. Adolescence may provide an ideal time for cognitive enhancement and intensive psychosocial intervention.

CHA2DS2-Vasc score, age and body mass index as the main risk factors of hyperintense brain lesions in asymptomatic patients with paroxysmal non-valvular atrial fibrillation

BackgroundThe aim was to assess the occurrence, severity and risk factors for silent white matter hyperintensities (WMH) in brain magnetic resonance imaging (MRI) in patients with atrial fibrillation (AF) and to determine the potential relationship between WHM and cognitive decline. MethodsSeventy-four patients with paroxysmal non-valvular AF were enrolled (age 59 (IQR 50–63)years, males 45/61%). All patients were on adequate warfarin treatment before inclusion and had no history of stroke or TIA. The presence and severity of brain WMH were classified according to the Fazekas scale, while general neurocognitive function was assessed using the Mini-Mental State Examination (MMSE). ResultsWMH were found in 51 patients (67.6%; age: 59±7.9years; males: 29/58%). CHADS2-VASc score (OR for 1 point 2.18; 95% CI=1.3–3.65; p=0.003), age (OR for 1year 1.11; 95% CI=1.04–1.18; p=0.001) and BMI (OR for 1kg/m2 1.23; 95% CI=1.04–1.45; p=0.017) were independent factors of any brain lesions. A positive correlation between Fazekas scale score and CHA2DS2-VASc score was shown in the entire group (Gamma 0.48; p<0.001). In the group with brain lesions, AF time (p=0.02) and LVEDD (p=0.03) significantly determined the Fazekas scale score (lesions severity). There were no differences in the MMSE score between patients with and without WMH (median: 28 (IQR 27–29) vs 29 (IQR 27.5–30); p=0.2). ConclusionsBoth the presence and severity of brain WMH are related to the CHADS2-VASc score and are not connected with cognitive impairment in this population. Age, BMI, AF time and the indices of heart remodeling constitute important factors influencing brain lesions.

Improved visual, acoustic, and neurocognitive functions after carotid endarterectomy in patients with minor stroke from severe carotid stenosis

Carotid endarterectomy (CEA) is an established operation performed to prevent strokes, but its other potential effects, such as improving neurocognitive, visual, and auditory functions, remain unconfirmed. This study examined these effects of CEA on patients with symptomatic carotid stenosis. This was a prospective controlled study that included 80 patients with minor strokes who had severe extracranial internal carotid stenoses (>70%). Forty patients, who did not receive or who postponed the CEA due to concerns about age, fear of surgery, limited life expectancy because of cancer, or financial problems, formed the medicine-treatment group. Another 40 patients who received CEA 1 week after recruitment formed the CEA group. For both groups, visual acuity chart tests, perimetry tests, audiometry tests, and neurologic scales (National Institutes of Health Stroke Scale, Mini Mental State Examination, and Barthel Index of Activities of Daily Living) were used to assess ophthalmic functions, auditory acuity, and neurocognitive functions before treatment and 3 months after treatment. Intragroup and intergroup comparisons were conducted to examine the effect of CEA. No deaths or strokes occurred during the 3-month follow-up. The intragroup and intergroup comparisons of ipsilateral function showed that CEA could improve visual acuity, visual field, and auditory acuity at all tested frequencies (250 Hz, 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz) and could improve the visual field and the auditory acuity for contralateral functions at 1000 Hz. The auditory acuity at 2000 Hz and 4000 Hz were unchanged in the intragroup comparison but showed no deterioration in the intergroup comparison with the medicine group. General neurocognitive function and independent living ability were significantly improved by CEA, as shown by intergroup comparisons (change rate of National Institutes of Health Stroke Scale: -8.1% ± 9.0% vs -2.7% ± 3.0%, P < .001; change rate of Mini Mental State Examination: 15.5% ± 10.5% vs 1.6% ± 2.6%, P < .001; change rate of Barthel Index: 28.0% ± 24.6% vs 2.0% ± 5.5%, P < .001). In patients with minor strokes caused by severe carotid stenosis, CEA improves neurocognitive, ophthalmic, and acoustic functions. Studies with a larger sample and longer follow-up are needed to substantiate these results, and the underlying mechanisms need further investigation.

Child Neuroanatomical, Neurocognitive, and Visual Acuity Outcomes With Maternal Opioid and Polysubstance Detoxification

BackgroundMaternal opioid and polysubstance use during pregnancy is associated with an increased risk of child neurocognitive and visual problems and neuroanatomical differences. We hypothesized that, in contrast to findings from a previous study of children born to mothers not detoxified, children born to detoxified mothers would not show gross neuroanatomical and neurocognitive differences. MethodsMothers with opioid and polysusbstance abuse problems and their infants (n = 11 + 12) were recruited from residential treatment institutions. Comparison mothers and infants (n = 12 + 12) were recruited from child health centers. The studies were approved by the Regional Committee of Medical Research Ethics. Children had magnetic resonance imaging scanning, neurocognitive, and visual acuity testing at 4.5 years. Neuroanatomical, cognitive, and visual acuity characteristics were compared across groups by analysis of variance and general linear models. ResultsThere were no significant differences across groups in neuroanatomical volumes, or cortical thickness, area, or volume. There were no differences in general neurocognitive functioning, but significantly lower left eye visual acuity, and a trend toward lower binocular visual acuity, in the drug-exposed relative to the comparison group. ConclusionsThe present study does not demonstrate gross differences relative to a comparison group in neuroanatomical and general neurocognitive characteristics of children born to mothers with opioid and polysubstance abuse who were detoxified during pregnancy. However, visual acuity was significantly lower in the drug-exposed group, requiring attention. There is a pressing need for additional and larger studies of long-term and specific child outcomes in this at-risk group.

The effect of electroconvulsive therapy on neurocognitive function in treatment-resistant bipolar disorder depression.

To compare the effects of right unilateral (RUL) electroconvulsive therapy (ECT) and algorithm-based pharmacologic treatment (APT) on neurocognitive function in treatment-resistant bipolar disorder depression. Inpatients with DSM-IV-TR-diagnosed, treatment-resistant bipolar depression, who were acutely admitted to 1 of the 7 clinical study centers in Norway, were recruited from May 2008 to April 2011 into a prospective, randomized controlled, 6-week acute treatment trial. General neurocognitive function was assessed with the MATRICS Consensus Cognitive Battery (MCCB), and retrograde memory for autobiographical events was assessed with the Autobiographical Memory Interview-Short Form (AMI-SF) before and shortly after (mean = 23.5 days) a trial with either RUL brief-pulse ECT (mean dose = 233.3 mC) or APT. Seventy-three patients entered, and 39 (nECT = 19, nAPT = 20) completed. Both groups showed improvements in all MCCB domain scores, with no significant differences between the study groups (no interaction effect: F₁,₃₇ = 1.52, P = NS). Improvements in neurocognitive performance were significantly correlated with reductions in depression ratings posttreatment. The AMI-SF score was significantly lower (based on consistent answers from pre- to posttreatment) in the ECT group (72.9%) than in the APT group (80.8%, P = .025), indicating reduced consistency in autobiographical memory after ECT. General neurocognitive function was unaffected by RUL brief-pulse ECT treatment and positively related to improved mood in bipolar depression. Autobiographical memory consistency was reduced in patients treated with ECT. The results suggest that ECT can be used in treatment-resistant bipolar depression without compromising general neurocognitive function. The clinical relevance of reduced autobiographical memory consistency in the ECT group requires further investigation. ClinicalTrials.gov identifier: NCT00664976.

The predictive significance of neurocognitive factors for functional outcome in bipolar disorder

Poor psychosocial functioning in bipolar disorder often persists even after affective symptom remission. Cognitive deficits, which have emerged as a core feature of bipolar disorder in the past few years, are among the factors implicated in adverse psychosocial outcomes of patients suffering from bipolar disorder. This review aims to overview recent literature on the association of neurocognition and psychosocial functioning in bipolar disorder. Cognitive deficits (mainly general neurocognitive functioning, attention and verbal learning and memory) are important determinants of poor psychosocial functioning in bipolar disorder, although to a lesser extent than in schizophrenia. Although affective symptoms appear to be a more important predictor of functional outcome in symptomatic patients, cognitive deficits also play a significant role, more readily recognizable in euthymic or chronic patients. Given the importance of cognitive impairments for psychosocial outcomes in bipolar disorder, the development of interventions targeting cognitive impairments is imperative for improving recovery rates and quality of life in patients, even after adequate symptom control.

Is the Repeatable Battery for the Assessment of Neuropsychological Status Factor Structure Appropriate for Inpatient Psychiatry? An Exploratory and Higher-Order Analysis

The present study, utilizing a sample of inpatients with schizophrenia or schizoaffective disorder (n = 167), examined the factor structure of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Principal axis exploratory factor analysis, multiple factor extraction criteria, and higher-order factor analysis were used. Results were inconsistent with the five-factor structure of the RBANS purported in the test manual. Factor extraction criteria recommended extraction of one or two factors. Extraction of two factors resulted in a memory dimension and a less homogeneous visual perception and processing speed dimension. Higher-order analysis found that a second-order factor, representing general neurocognitive functioning, accounted for over three times the total and common variance than the two first-order factors combined. It was concluded that although the RBANS appears to be a useful measure of general neurocognitive functioning for inpatients with schizophrenia or schizoaffective disorder, clinical interpretation beyond a general factor (i.e., Total Scale score) should be done with caution in this population. Limitations of the present study and directions for future research are discussed.

Neurocognitive correlates of liberalism and conservatism

Political scientists and psychologists have noted that, on average, conservatives show more structured and persistent cognitive styles, whereas liberals are more responsive to informational complexity, ambiguity and novelty. We tested the hypothesis that these profiles relate to differences in general neurocognitive functioning using event-related potentials, and found that greater liberalism was associated with stronger conflict-related anterior cingulate activity, suggesting greater neurocognitive sensitivity to cues for altering a habitual response pattern.

Neuropsychological functioning of youths with sickle cell disease: comparison with non-chronically ill peers.

To compare the neuropsychological functioning of children with sickle cell disease (SCD) with no evidence of overt clinical stroke to that of classmates without a chronic illness matched on gender, race, and age. We examined both overall level of performance and patterns of performance utilizing empirically derived construct scores of key domains of neurocognitive functioning. An abbreviated neuropsychological battery of tests was given to 31 children with SCD and 31 case controls. Empirically derived construct scores were developed for primary analyses. Children with SCD had significantly lower scores on three level-of-performance construct scores: total, verbal, and attention/memory. Mean scores for children with SCD were lower than those for case controls on every level-of-performance construct score and every standardized test score. However, pattern-of-performance construct scores were not significantly different. Children with SCD without overt stroke demonstrate significant deficits in neurocognitive functioning compared to classroom case controls. These findings highlight the impact of SCD on general neurocognitive functioning and suggest that routine screening of cognitive functioning should be a requisite element of comprehensive care for children with SCD. Within the context of documented physical limitations, we conclude that children with SCD are at very high risk for impaired psychosocial outcomes.